It's a painful fact: Most people who suffer from migraines are women. What's behind the gender difference, and what can women do about symptoms?

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It may not be fair, but it is a fact: Of the nearly 30 million people in the United States who suffer from migraines, about 75 percent are women.

And to add a bit of irony, many women who experience these often-debilitating headaches are the ones who can least afford to be sidelined. Most women who have migraines are between the ages of 20 and 45, which means that they are likely to be juggling responsibilities at home and at work. Women in this age group are often mothers of young children or busy with their careers or both. For these women, severe migraine symptoms that interfere with day-to-day activities can throw a big monkey wrench into their lives.

Compared to men, women also tend to have more painful and longer-lasting headaches that include other symptoms, such as nausea and vomiting. Migraine attacks may also be more severe around their menstrual periods.

How Hormones May Trigger Migraines

Doctors believe that hormones, especially estrogen, may play a role in migraine headaches. While experts aren’t exactly sure how hormones affect migraines, they do know that a woman’s estrogen and progesterone levels drop sharply just before a menstrual cycle begins. They also know that estrogen controls chemicals in the brain affect sensitivity to pain. That’s why shortly before a woman gets her period, falling estrogen levels may make her more vulnerable to feeling the pain of cramps, muscle aches — and headaches.

Some of the evidence that supports a link between hormones and migraines:

In children, girls and boys tend to get migraine headaches at about the same rate until they hit puberty, at which point there is a sharp increase in migraine headaches among girls who begin menstruating.

An estimated 60 percent of women experience migraine headaches several days before or during their menstrual cycle (though most will also experience attacks when they are not having their periods).

Women are also more likely to have migraine attacks around the middle of their menstrual cycles, when they are ovulating.

Pregnancy also seems to affect migraines. Many women report that their symptoms occur less frequently, are less severe, or even disappear completely during pregnancy. Others say the opposite, that pregnancy makes their migraine attacks worse.

As women near menopause, there is often an increase in migraine attacks.

Preventing Migraines

Since women are more vulnerable to migraine attacks shortly before or during their period, they should be particularly careful to avoid common migraine headache triggers around that time. Avoiding triggers is a good idea anytime, but it is especially important to be vigilant when the body is experiencing changes in hormone levels.

Some smart moves to keep migraines at bay:

Eat right. About a week before your period, try to stay away from carb-heavy foods, especially sweets and chocolate; these affect blood-sugar levels and can trigger migraine attacks. Other foods to avoid include alcohol and aged cheeses such as Brie and cheddar.

Don’t skip meals. Not eating can lower your blood sugar levels and make you hungry, which are common triggers for migraines.

Get enough rest. Sticking to a regular sleep schedule and getting about the same amount of sleep each night is important for reducing the risk of migraine attacks.

Exercise regularly. Working out for at least 30 minutes a day can help relieve stress, a common migraine trigger.

Try relaxation exercises and techniques. These include meditation and yoga, and have been shown to be effective in reducing stress.

Consider medications. If nothing else is working to prevent migraine attacks, talk to your doctor about taking medications a day or two before you expect migraine symptoms to strike. Some common drugs women can take to prevent migraine attacks include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen; an older class of drugs called ergot drugs; or one of the triptan drugs, a newer class of medications that has shown great results.

Work with your doctor to identify and avoid your migraine triggers, especially around the time that your body undergoes changes in hormone levels. With sustained effort, you may be able to prevent or at least better manage your migraine attacks.

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